Peadar Tóibín (Meath West, Aontú)
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690. To ask the Minister for Health if he will provide an up-to-date timeframe as to when he expects the statutory home support scheme to be finalised and operational. [22986/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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Work is ongoing to progress the development of the new home support scheme within the broader context of the ongoing reform of our health and social care system, as envisaged in the Sláintecare Report. The scheme will provide equitable access to high-quality services based on a person’s assessed care-needs. It is envisaged that the Heads of Bill, Memo for Government and Regulatory Impact Analysis will be brought to Government for approval before the end of this year.

Work is ongoing across four workstreams:

(i) Regulation of home-support providers

The Department is currently developing a regulatory framework for home-support providers with the aim of ensuring that all service-users are provided with high-quality care. This framework will comprise of primary legislation for the licensing of providers, secondary legislation in the form of regulations (minimum requirements), and HIQA national standards.

On 27 April 2021, Government gave approval to the Minister for Health to draft a General Scheme and Heads of Bill to establish a licensing framework for home-support providers. The Heads of a Bill are currently being drafted. This is being progressed by the Department with a view to bringing it through the Houses of the Oireachtas at the earliest opportunity. A Regulatory Impact Analysis is being progressed by the Department to ensure effectiveness and mitigate risks.

Development of regulations and standards are at an advanced stage. The Department has completed a targeted stakeholder consultation on draft regulations (minimum requirements) that will form the criteria against which a provider’s eligibility to hold a license will be determined. Draft regulations for home support providers have been developed by the department and amended following targeted stakeholder consultation. This has been enhanced by regular discussions with HIQA, HSE, Providers' representative groups and legal expertise assisting with legal text and interpretation of core issues, such as, capacity legislation, employment laws and health and safety issues. A 6-week public consultation was completed in August 2022 and the analysis of the results by the IPH was published in January 2023:

www.gov.ie/en/publication/56ab1-draft-regulations-for-providers-of-home-support-services-an-overview-of-the-findings-of-the-department-of-healths-public-consultation/

HIQA have conducted an evidence review on home support which was published on May 30th 2022. HIQA have developed standards for home care and home support services which will be the focus of a public consultation. The Department is also represented on the HIQA advisory group.

(ii)Financing of home-support services

The Department of Health is currently examining a range of funding options for home support. A policy dialogue showcasing recent national and international research commissioned by the Department of Health on future funding options for home support was held in March 2023.

The Economic and Social Research Institute (ESRI) undertook a programme of work on behalf of the Department on the potential demand for, and cost of, home support which culminated in two reports:

Demand for the Statutory Home Support Scheme (published in March 2021)

Home Support Services in Ireland: Exchequer and Distributional Impacts of Funding Options (published in February 2022)

A further report from the European Observatory on Health Systems was published in March of this year titled: “Improving Home Care Sustainability in Ireland. Are user charges a promising option?”

This research will form an important part of the evidence base for the development of a sustainable funding model for home support services in the context of our ageing population.

An internal consultation process on a range of potential funding options is underway. Targeted external consultation is also underway.

(iii) Reformed model of service delivery

The development of a reformed model of service delivery for home support and the testing of this across four pilot sites has concluded. The evaluation phase has commenced, with a final report expected shortly. The pilot commenced in November 2021 in East Westmeath in Community Healthcare Organisation CHO 8, three further sites came into operation in January 2022: Tuam, Athenry and Loughrea in CHO 2; Bandon, Kinsale and Carrigaline in CHO 4; and Ballyfermot and Palmerstown in CHO 7.

The rollout of interRAI as the single assessment tool for care needs in the community will assist with equitable resource allocation and InterRAI standardised outputs will be used to determine prioritisation and levels of care required. Service users will be assured of a fair and transparent care needs assessment.

The HSE has begun the recruitment process for 128 interRAI Care Needs Facilitators to progress the national rollout of interRAI as the standard assessment tool for care needs in the community.

The HSE is undertaking a recruitment process for a number of key posts to support the establishment of a National Home Support Office. Funding is provided for 15 full time jobs including 9 Community Healthcare Organisation home support manager/coordinator posts. A Head of Service has been appointed to the new Office, with the remaining posts to be filled as soon as possible this year. A proposed location in Tullamore for the National Home Support Office is being sourced by the HSE.

(iv) Implementation of the recommendations of the Strategic Workforce Advisory Group

In order to examine the significant workforce challenges in the home-support and nursing home sectors in Ireland, Minister Butler established a cross-departmental Strategic Workforce Advisory Group. The group was charged with identifying strategic workforce challenges in publicly and privately provided front-line carer roles in home support and nursing homes and with developing recommendations. The group examined issues such as the recruitment, retention, training, career-development, pay and conditions and barriers to employment for front-line carers in these sectors.

Their report was published in October 2022 with 16 recommendations in the areas of recruitment, pay and conditions of employment, barriers to employment, training and professional development, sectoral reform, and monitoring and implementation. Minister Butler strongly endorses these recommendations and they will be progressed through a dedicated implementation group. The report is available here:

www.gov.ie/en/publication/492bc-report-of-the-strategic-workforce-advisory-group-on-home-carers-and-nursing-home-health-care-assistants/

Recommendation no 9 has been implemented. The statutory instrument authorising the issuance of 1,000 employment permits for home-care workers was signed on 16th December 2022. To date, 17 organisations have availed of and utilised the process. According to statistics produced by the Department of Enterprise, Trade and Employment in April 2023, 54 permits have been issued to date.